A shifting paradigm in strengthening laboratory health systems for global health: acting now, acting collectively, but acting differently.

Improving clinical and public health laboratories should be one of the main goals of strengthening health systems, rather than a desirable afterthought. In this respect, in July 2009, several African countries, donors, the World Health Organization (WHO), and implementing partners met in Kigali, Rwanda, to launch a program for strengthening laboratory management, with the aim to accelerate national laboratory services toward accreditation in the African region. Before the 2009 meeting in Kigali, the need to strengthen laboratory networks, systems, and services in developing countries was highlighted in 2008 by several landmark events, including in January 2008, issuance of the Maputo Declaration for strengthening laboratory health systems; in April 2008, the Lyon statement on the need for developing countries to establish practical quality management systems; and in September 2008, the Yaoundé resolution issued by the WHO Regional Office for Africa (AFRO) that recognized the dilapidated state of the laboratory health systems and the need to strengthen them, as a priority, to fight multiple diseases. The recent focus on strengthening health systems and the emphasis on laboratory systems suggest that the opportunity has presented itself for the international community to act now, act collectively, but act differently to ensure sustainability of global health efforts to enhance laboratory networks and systems.